Pepper Spray Training

Learn how to keep yourself safe with our upcoming Pepper Spray Training class. Please fill out the form completely before submitting. If you have any questions, don't hesitate to contact us at 408-850-9479.

Participant Information

1st Participant's Name:

1st Participant's Age:

2nd Participant's Name:

2nd Participant's Age:

3rd Participant's Name:

3rd Participant's Age:

Please list any medical conditions, physical limitations, or other issues that Wushu Central should be aware of

Billing Information

Name on Card:

Address:

City:

State:

Zip:

Email:

Phone Number:

Class Fees

Pepper Spray Training is $39.99 for our 1-hour workshop plus $19.99 for equipment which includes a pepper spray kit. Registration spots may be limited. You will receive a confirmation by email that your spot is secure.

Credit Card Number:

Expiration Date:

Promotional Code: (optional)

Additional Comments

What To Bring

Please wear comfortable exercise-type clothing. For your safety, please do not wear jewelry. Note that participants must be age 16 and over.

Permission and Authorization

By submitting this form below, I hereby promise that I am the participant and/or the legal parent or guardian of the aforementioned "Participant(s)" and I authorize the "Participants" to participate in the Wushu Central Pepper Spray class.

By submitting this form, I acknowledge and understand that the Participant will be voluntarily engaging in activities that may involve contact and the risk of serious injury, permanent disability or death, and may cause severe social or economic losses due to not only my own actions, inactions, or negligence, but also to the action, inactions or negligence of

the Participant or other Participants

or Instructors, Volunteers and other employees of Wushu Central, Inc.

or Others or conditions of the premises or of any equipment used.

Further, I agree that I will not, nor will anyone acting on behalf of the Participant claiming by or through me or the Participant, bring or maintain any suit in Court to assert any claim against Wushu Central, Inc. and/or any instructors/assistant instructors, volunteers or other Wushu Central, Inc. Employee for any claim that might arise out of participation in any activities performed by, directed by or endorsed by Wushu Central, Inc. or the instructors/assistant instructors. Finally, the Participant understands that all physical activities are optional and he or she may refuse participation in the activity at any time.

Refund Policy

Class Fees are refundable or partially refundable based on the following time-table. Cancel: